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3 - Diagnosis of HIV infection in children

Published online by Cambridge University Press:  23 December 2009

By
Paul Krogstad
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Paul Krogstad
Affiliation:
Departments of Pediatrics and Molecular and Medical Pharmacology; David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Institutes of Health, Bethesda, Maryland
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Summary

Effective management of pediatric HIV-1 infection begins with timely and accurate diagnosis. In infants, early diagnosis is essential. Life-threatening immunodeficiency can develop rapidly and unpredictably, and there are no laboratory or clinical characteristics that accurately predict rapid or slow disease progression [1]. Studies in adults and children have shown that very early treatment can slow the progression of immunodeficiency and preserve HIV-1-specific immune responses. Early detection of HIV-1 infection among pregnant women is necessary to optimize medical care for the HIV-1-infected woman and to prevent mother-to-child transmission of HIV-1. This chapter outlines the use of serology, virus culture, and molecular diagnostic methods to detect HIV-1 infection.

HIV-1 Diagnostic assays

Detection of antibodies to HIV-1

In 1985, enzyme-linked immunosorbent (ELISA) and immunoblot (Western blot) assays were licensed in the United States for detection of HIV-1-specific IgG antibodies in serum. While other tests are now available, they remain the mainstay for serological diagnosis of infection.

ELISA assays detect all antibodies that react with HIV-1 proteins, and are an excellent method for rapid screening. Moreover, minor modifications, such as dilution of the test samples, allow samples with low antibody titers to be identified. This “detuned ELISA” has been successfully used to identify adults with recently acquired HIV-1 infection [2, 3]. In a high-risk population for HIV-1, the positive predictive value of ELISA testing is reported to exceed 99%. However, false-positive reactions still occur (see below), particularly when used in populations at low risk for HIV-1 infection.

Type
Chapter
Information
Handbook of Pediatric HIV Care , pp. 99 - 106
Publisher: Cambridge University Press
Print publication year: 2006

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References

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  • Diagnosis of HIV infection in children
    • By Paul Krogstad, Departments of Pediatrics and Molecular and Medical Pharmacology; David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.005
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Diagnosis of HIV infection in children
    • By Paul Krogstad, Departments of Pediatrics and Molecular and Medical Pharmacology; David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.005
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diagnosis of HIV infection in children
    • By Paul Krogstad, Departments of Pediatrics and Molecular and Medical Pharmacology; David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.005
Available formats
×